MavCARES

** If this is a true emergency where the lives of the student or other students are in danger, contact 911 or Campus Security at 507-389-2111 immediately. **

Purpose and Goal:

The purpose of the Early Alert Referral is to give faculty, staff, students and/or parents the opportunity to refer a student who has an academic concern such as excessive absences, a failing letter grade, or concerning behavior. The referral will go to the Office of New Student and Family Programs who will assess the situation, offer support and provide referrals to the appropriate resources on campus.

NOTE: In accordance with the Family and Privacy Act (FERPA), the structure is designed to allow referrals to be viewed only by those individuals who have a need to know. The information shared will not become a part of a student's permanent record. In addition, state and federal privacy laws prohibit the unauthorized disclosure of personally identifiable health information.

General Information (Please fill in all fields):

Referred by (Your name):

Your e-mail address:

Your phone number:

In what context do you know the student?

Student's Information:

Student name (first and last):

Tech ID number (if known):

Student class status:

E-mail address:

Cell Phone number:

On or Off campus residence?

On-campus

Off-campus

Comments on the contact information:

Reasons for Referral:

Academic Issues:

GradesAttendanceHomeworkOther. Please specify

This form is not the appropriate place to submit a report of Self Harm or Suicide. Contact University Security (507-389-2111) immediately.

Is this issue related to a specific course?

Yes

No

Have you already discussed the issue with the student?

Yes

No

Is this an issue that is URGENT (needing assistance in the next 24 hours) or IMPORTANT (action needed within 3 working days)?

Yes

No

** This service is monitored during regular office hours, not 24/7. **

Explain the situation and suggest how we can help.

We appreciate the dedication you have to the students here at Minnesota State University, Mankato. Thank you for taking the time to look out for this student and for taking the initiative to help the student succeed in every way possible.

Moving forward, our office will assess the situation and provide referrals to the appropriate resources on and off campus in order to provide the best support for this student.

If you have any further questions please contact the Office of New Student and Family Programs at 507-389-5498.